| NPI | 1699296459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102206618) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116030980) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-12-13 |